How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $3,235.94 Median $4,570.88 Typical High $7,943.28 | Facility | None | $3,235.94 | $4,570.88 | $7,943.28 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $128.82 | Professional | None | $54.95 | $91.20 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $794.33 Median $2,691.53 Typical High $7,762.47 | Facility | None | $794.33 | $2,691.53 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $112.20 Typical High $186.21 | Professional | None | $63.10 | $112.20 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $51.29 Typical High $1,000.00 | Facility | None | $50.12 | $51.29 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $120.23 Typical High $218.78 | Professional | None | $81.28 | $120.23 | $218.78 |
ConnectiCare Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $446.68 | Professional | None | $131.83 | $213.80 | $446.68 |
Health New England Setting Facility Modifier None Typical Low $144.54 Median $1,288.25 Typical High $4,073.80 | Facility | None | $144.54 | $1,288.25 | $4,073.80 |
Health New England Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $204.17 | Professional | None | $104.71 | $204.17 | $204.17 |
United Setting Facility Modifier None Typical Low $251.19 Median $1,548.82 Typical High $4,466.84 | Facility | None | $251.19 | $1,548.82 | $4,466.84 |
United Setting Professional Modifier None Typical Low $61.66 Median $120.23 Typical High $239.88 | Professional | None | $61.66 | $120.23 | $239.88 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $35.48 Median $38.90 Typical High $52.48 | Professional | 52 · Reduced service | $35.48 | $38.90 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $15.49 Typical High $20.89 | Professional | 53 · Discontinued | $14.13 | $15.49 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $58.88 Typical High $79.43 | Professional | 54 · Surgery only | $53.70 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.75 Typical High $15.85 | Professional | 55 · Aftercare only | $10.72 | $11.75 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.76 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.08 | $7.76 | $10.47 |
Where Connecticut sits
The same service costs 3.2 times more in Alaska than in New York. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 19th of 51
$112
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.